Healthcare Provider Details

I. General information

NPI: 1487333233
Provider Name (Legal Business Name): FARAH MOHDNOAR KHAYRI ALBITAR MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/17/2023
Last Update Date: 02/17/2026
Certification Date: 02/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 CHILDRENS PL, MSC 8116-0043-10
SAINT LOUIS MO
63110
US

IV. Provider business mailing address

1 CHILDRENS PL, MSC 8116-0043-10
SAINT LOUIS MO
63110
US

V. Phone/Fax

Practice location:
  • Phone: 314-454-6051
  • Fax: 314-454-6225
Mailing address:
  • Phone: 314-454-6051
  • Fax: 314-454-6225

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number4351051110
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: